How to Get Reimbursed for Therapy: What to Do If You Have Insurance and Want the Right Therapist?
- Stephanie Buckley
- Oct 28
- 3 min read
By Stephanie Buckley,AMFT ADHD Parenting Strategist & Family Systems Coach
The Path to Peace Therapy Hermosa Beach, California
So You Have Insurance But What Kind Is It, and What Does It Actually Cover?
You’ve decided it’s time to get help. You’re ready to work with a therapist who actually gets it someone who can offer real strategies, tools, and insight to create change in your life
You start looking… and then realize you’re not even sure what kind of insurance you have. HMO? PPO? Does it matter?
It absolutely does.
Understanding your insurance type can make the difference between being limited to whoever your insurance assigns you versus choosing the therapist who’s actually the right fit for your goals, personality, and needs
HMO vs. PPO: The Quick Breakdown
• HMO (Health Maintenance Organization):
Think of it as a closed circle. You have to stay within your insurance network. To see a specialist or therapist outside of that circle, you usually need a referral or pre-authorization
and often, it’s just not covered.
• PPO (Preferred Provider Organization):
PPO plans give you flexibility. You can choose any licensed therapist, even if they’re not in-network. You pay your therapist directly, and your insurance may reimburse you for part of the cost.
If you’ve discovered that you have a PPO, congratulations that flexibility is gold. It means you can choose the therapist who best fits your life, not just the one who’s listed on a panel.
So What’s a Superbill and How Does It Work for You?
A superbill is your secret weapon for getting reimbursed.
It’s a detailed receipt your therapist provides that includes everything your insurance company needs: your name, diagnosis code (if applicable), CPT code, fee, and the date of service.
Here’s how it works:
1. You pay your therapist directly.
2. Your therapist gives you a superbill after each session.
3. You upload that superbill to your insurance company (usually through their online portal or app).
4. A few weeks later, you receive reimbursement sometimes up to 40–80% back, depending on your deductible and plan.
That’s it. It’s not complicated, just underutilized.
Why People Choose Out-of-Network Therapists Anyway
Many clients start with the idea that staying “in-network” will save them money.
But what they find instead is:
• Long waitlists
• Therapists who don’t specialize in their concerns
• Limited session lengths or duration of care
Working out-of-network allows you to find the person who’s the right fit someone who’s not only licensed but deeply aligned with what you’re working on.
You’re not paying for “a session.” You’re investing in solutions that bring tangible change to your home, your relationships, and your emotional baseline.
The Real Benefits of Working Out-of-Network
Privacy
Your insurance company doesn’t receive any of your therapy notes or mental-health diagnoses. What you share in session stays between you and your therapist — not in a claims database.
Personalization
We can tailor therapy to your real-life goals, not a pre-set number of sessions. That means we can focus on executive functioning, co-parenting strategies, or ADHD management without insurance dictating what’s “medically necessary.”
Flexibility
Together, we decide what frequency and format work best in-person, virtual, or hybrid. If you’re a parent, a college student home for the holidays, or a working professional balancing a full plate, therapy adjusts to you, not the other way around.
Serving the South Bay and California
At The Path to Peace Therapy, I work with clients across the South Bay, including Hermosa Beach, Manhattan Beach, Redondo Beach, El Segundo, Torrance, and Palos Verdes, as well as virtually throughout California.
Whether you’re navigating anxiety, ADHD, OCD, or burnout or simply ready to create systems that help your family function better you deserve therapy that’s effective, not complicated.
Visit my Fees &. Insurance page to learn nore about PPO and reimbursement or schedule a complimentary 15 minute consultation and get on a to path to peace today!
Contact me: Stephanie Buckley 310-991-8768
Email me: StephanieB@ThePathToPeaceTherapy.com
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